Multifocal motor neuropathy: controversies and priorities

Wei Zhen Yeh, P. James Dyck, Leonard H. Van Den Berg, Matthew C. Kiernan, Bruce V. Taylor

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Despite 30 years of research there are still significant unknowns and controversies associated with multifocal motor neuropathy (MMN) including disease pathophysiology, diagnostic criteria and treatment. Foremost relates to the underlying pathophysiology, specifically whether MMN represents an axonal or demyelinating neuropathy and whether the underlying pathophysiology is focused at the node of Ranvier. In turn, this discussion promotes consideration of therapeutic approaches, an issue that becomes more directed in this evolving era of precision medicine. It is generally accepted that MMN represents a chronic progressive immune-mediated motor neuropathy clinically characterised by progressive asymmetric weakness and electrophysiologically by partial motor conduction block. Anti-GM1 IgM antibodies are identified in at least 40% of patients. There have been recent developments in the use of neuromuscular ultrasound and MRI to aid in diagnosing MMN and in further elucidation of its pathophysiological mechanisms. The present Review will critically analyse the knowledge accumulated about MMN over the past 30 years, culminating in a state-of-the-art approach to therapy.

Original languageEnglish (US)
Pages (from-to)140-148
Number of pages9
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume91
Issue number2
DOIs
StatePublished - Feb 1 2020

Keywords

  • GANGLIOSIDE
  • NEUROIMMUNOLOGY
  • NEUROPATHY
  • NEUROPHYSIOLOGY
  • PERIPHERAL NEUROPATHOLOGY

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology
  • Psychiatry and Mental health

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